Editorial

Left Ventricular Noncompaction of the Ventricular Myocardium: Ever a Challenging Diagnosis

Authors: Angelos Rigopoulos, MD, Ioannis Rizos, MD, Dimitrios T. Kremastinos, MD

Abstract

Noncompaction of the ventricular myocardium is currently listed as an unclassified cardiomyopathy.1 This relatively new entity, first described in 1990,2 poses a problem of differential diagnosis in patients presenting with heart failure.


Left ventricular noncompaction (LVNC) is characterized by multiple, prominent trabeculations of the left ventricular endocardium and deep intertrabecular recesses, which communicate freely with the left ventricular cavity. Right ventricular myocardium can also be trabeculated, but persistence of prominent trabeculations in the left ventricle is normally not seen after birth. Thus, LVNC appears to represent an arrest in the intrauterine endomyocardial morphogenetic process of myocardial compaction. This process begins in the 2nd month of embryonic life, when the heart is a “spongy,” loosely interwoven mesh of muscle fibers which gradually compacts from the epicardium to the endocardium and from the base to the apex.

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